Provider Demographics
NPI:1205454931
Name:HARMON, MATTHEW ADAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ADAM
Last Name:HARMON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9812 MISTY PINE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8263
Mailing Address - Country:US
Mailing Address - Phone:901-461-4745
Mailing Address - Fax:
Practice Address - Street 1:3444 PLAZA AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4614
Practice Address - Country:US
Practice Address - Phone:901-324-1013
Practice Address - Fax:901-325-1452
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist